Of the seven people who
contracted Marburg in Luanda, two have died an Italian doctor and a
15-year-old boy who both came from Uige. <<

The case fatality
rate and transmission of Marburg outside of the
epicenter in Uige need to be clarified. Marburg and Ebola are two
closely related single stranded, negative sense RNA viruses. They
are the two Filoviridae.
The associated fatality rate can vary markedly. In the largest
prior outbreak of Marburg, the case fatality rate was 83%. That
outbreak was in the Democratic Republic of the Congo between 1998 and
2000. 123 out of 149 patients died.

There have been similar large outbreaks for Ebola, but the case
fatality rate can vary. In 1976 in Zaire, 280 out of 318 patients
died giving a case fatality rate of 88%. However, in southern
Sudan in the same year, the case fatality rate was only 42%, with 117
out of 284 patients dying.

The case fatality rate for the current Marburg outbreak in Angola is above
90%, and may actually be close
to 100%, because several of the diagnosed cases are alive, but are
still
in the hospital. There have been no reports of recent discharges
of recovered patients.

The number of reported patients who have contracted Marburg in Luanda
appears to be limited
to a 12 year-old girl. The first two
fatalities in Luanda were a 15 year-old boy and an Italian
physician. However, both had come from Uige. Similarly, the
third
fatality was a Vietnamese physician who had also treated
patients in Uige. Two other patients hospitalized in Luanda had
also been from Uige. A sixth person hospitalized was a Portuguese
citizen who was hospitalized at a military hospital, but who had also
been in Uige.

The 12 year-old girl was initially admitted to a suburban Cacuaco
Health Centre. When she started to hemorrhage, she was
transferred to Americo Boa Vida hospital in Luanda. Thus, she
appears to be the only reported transmission in Luanda and the only
transmission outside of Uige. The fatality
in Cabinda had been to a funeral in Uige and the fatality
in Portugal is still under investigation.

However, since Marburg has an incubation period of 3-7 days, more
transmissions may have happened which have not been reported.
Moreover, the source of the infection in the 12 year-old also has not
been reported. Thus, the attention outside of Uige has been on
the one case in Luanda, although there are concerns that additional
cases will develop and the number of deaths will exceed the 122
reported
thus far.